Nor’easter Tests Hard-Pressed Hospitals, Weary Medical Personnel

Overtired and overstressed by last week's superstorm, NJ health professionals face another bout of bad weather.

For New Jersey’s health-care providers, the days following Hurricane Sandy have amounted to an endurance test, one that shows no signs of easing as hospital officials ramped up another emergency response Wednesday in expectation of more severe weather.

Overflowing emergency rooms, hospitals without power, and overburdened staff are just some of the problems that hospitals have faced in the past week -- and now fear will continue.

Hackensack University Medical Center was leading one of the more visible efforts in this preparation, as hospital personnel readied the hospital’s Mobile Satellite Emergency Department (MSED) at Ocean Medical Center in Brick Township.

The U.S. Department of Defense-funded MSED -- which rides on a 43-foot semi trailer -- includes an emergency room on wheels, with seven critical-care beds, oxygen, and digital radiography.

It serves a life-and-death purpose.

Temporary emergency rooms are necessary in stricken regions, since ERs have been crowded with patients who could not reach doctors or have been injured during Sandy and its aftermath. In some parts of the state, ERs were seeing two and three times the normal volume.

Dr. Joseph Feldman, chairman of emergency medicine at Hackensack, noted that this would be the third time the mobile unit had been deployed since the superstorm struck, following a brief stay in Somerset County -- where personnel delivered a premature baby -- and a previous several-day visit to Brick.

Getting the MSED ready to move out was one of several storm-related tasks that state Department of Health officials were involved in on Wednesday.

Getting Ready for the Next Storm

Health Commissioner Mary E. O’Dowd said it was important that hospitals and other providers are prepared for the nor’easter.

“I remain concerned about all of our healthcare facilities,” O’Dowd said, explaining that they are stretched to their limits with healthcare personnel working long hours.

O’Dowd has been taking daily conference calls with local emergency and health officials since Oct. 25, four days ahead of Sandy’s landfall. She also has been speaking with hospital and nursing home executives, including a call with healthcare CEOs on Wednesday.

Her advice: Rely on generators and have plenty of fuel on hand to run them.

“We don’t want to have a situation where we have an unnecessary evacuation because people weren’t prepared,” O’Dowd said, adding the traditional warning: “You can’t turn your back on the ocean.”

The daily conference calls have covered a range of topics, O’Dowd said, including the establishment of temporary medical shelters -- places for people who have more routine medical needs to be housed and treated -- and the provision of fuel, both to power generators and to ensure the medical providers have transportation.

O’Dowd said the shelters were important in relieving pressure on emergency rooms, which have seen a rise in visits while doctors’ offices are closed.

Emergency departments also have seen increased volume from patients injured while trying to remove fallen debris.

Treating the 'Medically Fragile'

Kerry McKean Kelly, spokeswoman for the New Jersey Hospital Association, noted that demand on emergency rooms has increased due to “medically fragile” New Jerseyans who seek them out. These individuals, who aren’t facing true emergencies, go to hospitals “because they know that it’s open, they know it has power, they know that there are people there who will take care of you.”

Hospitals “are prepared to just ramp up staff and just care for those patients,” McKean Kelly said.

Making sure that staff was available was made easier by the Department of Transportation's decision to open fuel depots to credentialed doctors and nurses.

Some hospitals were forced to shift patients during the storm, due to temporary closings. For instance, efforts to restore service at Palisades Medical Center and Hoboken University Medical Center, which were closed due to the storm, are continuing. O’Dowd commended the staffs for their handling of the situation, including having hospital employees move with their patients to Bayonne Medical Center and Christ Hospital.

Hurricane Sandy’s effects are not “behind us, but it seems to be easing, especially the gasoline situation,” McKean Kelly said, adding that hospitals still face high volumes of patients.

The continuing response to the storm extended beyond emergency personnel to other health-care providers, like pharmacies. New Jersey Council of Chain Drug Stores executive director John Holub said pharmacies continue to work with customers, some of whom have been displaced by Sandy.

Holub noted the problems involved in providing medication and having patients take appropriate dosages under difficult circumstances. “There have been some challenges, obviously, with people not going to the same pharmacy they typically go to,” he said.

Holub said the federal Emergency Prescription Assistance Program, which allows pharmacies to dispense month-long prescriptions to low-income and disabled residents in disaster areas, has been helping the industry take care of customers.

“It does make it easier for pharmacists to dispense necessary medication to residents in the greatest need,” said Holub, whose association includes 800 stores.

Assisting Medical Staff

While health-care providers work to meet demand and prepare for the nor’easter, they were also attempting to help staff members who suffered losses during the storm. Barnabas Health officials said they immediately provided funds to workers who were homeless or without transportation.

“We were able to react faster than insurance companies or the government in delivering direct assistance to those with needs that could not wait,” Barnabas vice president of public relations and marketing Ellen L. Greene said in a statement.

Barnabas sites offered staff member free meals, use of computers to take care of online business, places to wash and dry clothes, and carpooling programs.